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General NPI Number Information
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NPI Number | 1457652869
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Entity Type | Individual
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Provider Name | MICHAEL R LARSON N.D.,D.C.,LA.C
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Gender | Male
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 11/16/2010
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Provider Practice Location Address
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Address Line | 9316 CARNATION DUVALL RD NE
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City | CARNATION
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State | WA
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Zip | 98014-6706
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Country | US
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Telephone | 206-679-1957
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Fax | 425-788-3831
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Provider Business Mailing Address
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Address Line | 9316 CARNATION DUVALL RD NE
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City | CARNATION
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State | WA
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Zip | 98014-6706
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Country | US
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Telephone | 206-679-1957
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Fax | 425-788-3831
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH 00000712
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC 00000398
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | NT 00000534
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License Number State | WA
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